Drug & supplement interaction

Indian Long Pepper + Vinblastine

Vinblastine brand name: Velban.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Vinblastine falls into 2 drug categories that Indian Long Pepper can interact with; the most serious is rated moderate. Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Indian Long Pepper and Vinblastine

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Indian Long Pepper interacts with whole categories of medication. Vinblastine falls into 2 of those categories, so it can interact with Indian Long Pepper in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Vinblastine

Vinblastine falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Indian Long Pepper interacts with.

Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.
In vitro research shows that piperine, a constituent of Indian long pepper, inhibits CYP3A4.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: vinblastine is cleared by an enzyme in your body called CYP3A4, and the piperine in Indian long pepper may slow that enzyme down. If vinblastine is broken down more slowly, more of it can hang around in your blood. With a potent chemo drug like this, that could mean stronger side effects, things like a bigger drop in your white blood cell counts (raising infection risk), nerve tingling or numbness, constipation, and mouth sores.

I want to be honest about the strength of this concern, though. It comes from lab (test tube) studies only, not from people, so it's theoretical. Still, because vinblastine is so powerful, I'd play it safe. Please tell your oncologist or pharmacist before using long pepper supplements so they can guide you.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50. PubMed
Moderate

P-GLYCOPROTEIN SUBSTRATES

2 of 2

Vinblastine also falls under P-GLYCOPROTEIN SUBSTRATES.

Theoretically, Indian long pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of Indian long pepper, can inhibit P-glycoprotein.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for vinblastine: your body uses a kind of cellular bouncer called P-glycoprotein to pump this chemo drug out of cells and help clear it. The piperine in Indian long pepper may slow that pump down. In theory, that could let more vinblastine linger in your system, nudging its levels higher.

With a powerful chemo agent like this, higher levels can mean more of the side effects you'd expect, things like low blood counts (raising infection and bleeding risk), nerve tingling or numbness, constipation, and mouth sores. That said, this is a theoretical concern based only on lab studies, not real patient cases. Still, vinblastine has very little wiggle room, so please loop in your oncology team or pharmacist before using long pepper supplements.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50. PubMed
  2. Han, Y., Chin Tan, T. M., and Lim, L. Y. In vitro and in vivo evaluation of the effects of piperine on P-gp function and expression. Toxicol.Appl.Pharmacol. 8-1-2008;230(3):283-289. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Indian Long Pepper Also Interacts With Other Medications

Indian Long Pepper has 892 moderate, 3 minor known drug interactions in our database — the Vinblastine one above is among them. If you take anything else, check it against the full list below.

Moderate 892 Minor 3 No known interaction 1,935 (incl. Vinblastine)
Taking anything else?

Check Another of Your Medications Against Indian Long Pepper

Covers the 2,830 medications we’ve checked against Indian Long Pepper. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Vinblastine

This page covers Indian Long Pepper only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Vinblastine page lists 161 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 119 moderate · 39 minor.

From our pharmacist’s overview on the Vinblastine page

“Vinblastine (Velban) is intravenous chemotherapy, most often for lymphomas and testicular cancer, and its safety margin is thin enough that I treat every supplement on this list as a real question, not a formality. Of the 161 ingredients on file, three rate major, and those three deserve attention first: grapefruit and St.”

Reviewed by 2 · Jul 18, 2026

Open the Vinblastine interaction page

One more smart check

Taking Indian Long Pepper as Part of a Dietary Supplement Product? Check It for Interactions

We hold 597 real supplement products containing Indian Long Pepper, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Indian Long Pepper. Your product may carry other ingredients that interact with Vinblastine too, on top of Indian Long Pepper — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Indian Long Pepper and Vinblastine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Indian Long Pepper
Top 25%

#194 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Vinblastine
Steady interest

#1,979 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Indian Long Pepper

What is Indian Long Pepper?

Indian Long Pepper
  • Digestive upset
  • Respiratory and cough complaints
  • Boosting absorption of other supplements
  • Pain and inflammation
  • General wellness in Ayurveda

Indian long pepper (pippali) is a spice long used in Ayurvedic medicine and is best known for its piperine content, which may increase how well the body absorbs certain other substances. Modern human research on its health benefits is limited, so use it cautiously and let your pharmacist or doctor know if you take it regularly.

Read the full Indian Long Pepper monograph & all interactions
Medication

About Vinblastine

What Is Vinblastine Used For?

Brand name: Velban

Vinblastine Sulfate Injection is used in the treatment of a range of cancers. Conditions that tend to respond well include generalized Hodgkin's disease, lymphocytic lymphoma, histiocytic lymphoma, advanced mycosis fungoides (a type of skin lymphoma), advanced testicular cancer, Kaposi's sarcoma, and Letterer-Siwe disease (a rare immune condition also called histiocytosis X).

It may also be used for cancers that respond less reliably, such as choriocarcinoma resistant to other chemotherapy drugs, and breast cancer that has not responded to hormonal therapy. Vinblastine is often given as part of a combination chemotherapy regimen alongside other cancer medicines to improve response rates.

See full Vinblastine drug information
Keep checking

Other Drugs & Indian Long Pepper

Browse every other medication we’ve checked against Indian Long Pepper — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
892Moderate
3Minor
1,934No known interaction
892 Moderate 3 Minor 1,934 No interaction
Moderate

892 interactions

Showing 60 of 892 moderate interactions — see all 892 on the Indian Long Pepper page.

Minor

3 interactions

No interaction 1,934 drugs checked — show the list

We also checked Indian Long Pepper against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,934 medications checked with no known interaction — see the full Indian Long Pepper list.

See the full Indian Long Pepper interactions page
See every supplement checked against Vinblastine, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Indian Long Pepper monograph › Uses, safety, and every drug interaction in one place Vinblastine supplement interactions › Every supplement checked against Vinblastine, ranked by severity Vinblastine drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Indian Long Pepper and Vinblastine Together: Common Questions

Can you take Indian Long Pepper with Vinblastine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Indian Long Pepper and Vinblastine?
Vinblastine belongs to more than one drug category, and Indian Long Pepper interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Indian Long Pepper and Vinblastine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Vinblastine and Indian Long Pepper?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.